OTHER METHODS OF BIRTH CONTROL
INTRA UTERINE DEVICE or IUD is a fashioned historical method to prevent pregnancy by inserting a device into the vigina and make to to stay there to produce longer effects of contraception.
Historically it was rumored that some Arab pagans inorder to prevent the births of several calfs as a burden to their female camels they inserted small stones into their uteruses through their vagina to prevent conception.
This historical basics has been used to develop devices with higher technology.
There are two types of IUDs,the hormonal and non hormonal.The hormonal IUDs contains usually a progestin such as a slow release levonorgestrel.The other nonhormal IUDs contains a copper spring.Both the IUDs are yielding a reversible contraception.The effects of copper IUDs are longer than the hormonal IUDs.The hormonal IUDs like Mirena is found to be effective upto 5 years while as the copper IUDs can give the effects upto 7 years.
The insertion should be done by an experienced physician.
As seen in the above figure the IUD should be correctly positioned by the help of a speculum a medical device used for inserting a device through any small opening or orifice like vagina.
Before insertion the pelvic portion should be thoroughly examined for any inflammation,injury or infection like chlamydia and gonorrhea.The position and shape of the uterus should be confirmed through the pelvic exam.
During the insertion the vagina is held open by a speculum.The cervix should be grasped by a grasping instrument.The leangth of the uterus must be measured for proper insertion.Now the IUD must be carefully inserted through the cervix by using a narrow tube into the uterus.A short narrow monofilament plastic/nylon string attached to the device should be come and hang out through the vagina for the convenience of the patient to check the IUD position later on at times.
The above video gives an explanation of the inserting methods.
Mechanisms of Actions
1.Make uterus hostile to the fertilized ovum
2.The endometrium becomes thin and not hospitable to the ovum
3.The cervix become thick and sperm cannot penetrate it.
4.Unimportantly sometimes ovulation is retarded
Advantages:-
1.Longer effects
2.No need to take any systamic medications like pills and injections
3.Most of the released hormone from the hormonal IUDs are absorbed and stay within the uterus by leaving a negligible minute quantity into the system.
4.Reversible contraception
5.Inexpensive as they are made out of plastics.
6.The copper IUDs are totally harmless during breast feeding.But there are no known guarentee for hormonal IUDs.
7.No prior care or preparations needed before sex,but the patient has to check the string at times to ensure the device is staying in proper place.
Disadvantages:-
1.Risks of ectopic pregnancy,the pregnancy happened outside the uterus usually at the tube.
2.Irregular heavier periods and spotting
3.Menstrual cramping and back pain.
4.Painful intercourse experienced by some women.
5.Rare but serious perforation of uterus.
6.Pelvic pain and inflammation leads to serious infections.
Conraindications:-
1.Patients who take blood hinners like aspirin,warfarin and clopidrogel
2.Those who use copper IUD must avoid exposure to microwaves or any short waves such as ultra violet radiations.
3. Teen agers and women who gave several births are commonly experiencing displacement or expulsion of the device and hence should be careful in their movements.
4.Pelvic infections
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